Fairfax Radiological Consultants

To Schedule an Appointment Call:
703.698.4488

Prostate Artery Embolization

What is PAE?

Prostate Artery Embolization (PAE) is a minimally invasive, non-surgical outpatient treatment to treat Benign Prostatic Hyperplasia (BPH) or enlarged prostate. Using a live x-ray, an interventional radiologist inserts a thin IV catheter into the groin or wrist artery and guides it through the prostate artery.  Once the correct vessels are identified, a mixture of small beads (microparticles) is injected to fill areas of the prostate gland being supplied by the blood vessel.  These beads stay permanently in the prostate gland and will force it to shrink over time.  Over time, the prostate shrinks, improving lower urinary tract symptoms.  This FDA-approved procedure is performed at Fairfax Vascular Center.

What is Benign Prostatic Hyperplasia (BPH)?

Benign Prostatic Hyperplasia is the medical term for non-cancerous enlarged prostate.  The typical prostate size of the adult male is about the size of a golf ball.  When enlarged, the size can increase to the equivalent of a lemon, obstructing urine flow from the bladder and out the urethra.

Am I at risk?

Enlarged prostate is common as men age, affecting one in four men by age 55, and half of 75-year-old men. Most men will experience lower urinary tract symptoms to varying severity.  The treatment is determined by the severity of symptoms.  In severe cases, an enlarged prostate can lead to urinary tract infections, bladder or kidney damage, bladder stones or incontinence.

What are the symptoms?

Some lower urinary tract symptoms that are associated with an enlarged prostate include:

pae01 INABILITY TO EMPTY BLADDER COMPLETELY pae02 URGENCY, FREQUENCY pae03 MULTIPLE NIGHT-TIME AWAKENINGS TO URINATE pae04 OCCASIONALLY URINARY RETENTION

What are my treatment options?

Numerous treatment options exist for enlarged prostate, ranging from conservative to invasive. These include medication to improve flow of urine and decrease the size of the prostate.  Transurethral treatments include Trans Urethral Resection of the Prostate (TURP), laser ablation/enucleation.  Additional outpatient treatments include Rezum or UroLift.  Finally, surgical treatments include prostatectomy.  Prostate Artery Embolization is a very effective non-surgical, non-transurethral treatment.  

Every patient’s treatment goals and risk tolerance is different.  Your interventional radiologist will help guide to your preferred treatment, address your concerns and compare and contrast risks and benefits of various treatment pathways. No one treatment will suit the needs and goals of each patient.

Artboard Can be done at any prostate size Non-surgical treatment Can be repeated, and does not prevent alternative therapies in future No hospital stay Blood thinners are not necessarily a contraindication Preserves sexual function Takes several weeks to take effect Size limitations prevent all prostates from being candidates Patient health limits candidacy for the procedure Works extremely well in relieving urinary symptoms Requires patient to come off anticoagulation Can have post operative and intraoperative bleeding Can affect sexual function adversely Typically benefits are experienced immediately Prostate Artery Embolization PAE TURP Transuretheral Resection of the Prostate PAE vs . TURP

Lead in statement for completing the questionnaire will go here.

Questions Not at all Less than one time in five Less than half the time About half the time More than half the time Almost always
How often have you had the sensation of not emptying your bladder completely after you finished urinating?
How often have you had to urinate again less than two hours after you finished urinating?
How often have you found you stopped and started again several times when you urinated?
How often have you found it difficult to postpone urination?
How often have you had a weak urinary stream?
How often have you had to push or strain to begin urination?
Questions None One Time Two Times Three Times Four Times Five or More Times
How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?

Total International Prostate Symptom Score =  

1 – 7 mild symptoms | 8 – 19 moderate symptoms | 20 – 35 severe symptoms

Regardless of the score, if your symptoms are bothersome you should notify your doctor.

Am I a candidate for PAE?

Most patients with typical lower urinary tract symptoms are candidates for prostate artery embolization. The key benefits of PAE are few if any complications and no lasting sexual side-effects. Patients are candidates for PAE even if they are not candidates for a transuretheral surgical procedure. Patients with bleeding originating from the prostate gland, indwelling catheters for urination, or non-surgical candidates are also suitable for PAE. Patients with chronic non-bacterial prostatitis may also be candidates for treatment. Your interventional radiologist will go over your clinical history in detail during the consultation.

The benefits of treatment include:

pae05 REDUCTION 50-75% In Overall Symptoms pae06 IMPROVEMENT IN QUALITY OF LIFE 60% pae07 IMPROVEMENT 50% In Chronic Prostatitis Symptom Survey pae08 MAJOR COMPLICATION RATE OF < 1% pae09 For At Least 5 to 7 Years, Based on Current Research DURABLE RELIEF IN OF PATIENTS 85%

Watch the video below to learn about PAE treatment

Why Choose Fairfax Vascular Center?

Over 100 years of combined clinical experience.

Fairfax Vascular Center is one of the largest, long-established interventional radiology practices with more than 100 years of combined clinical experience.

Specialize in Prostate Artery Embolization.

Since the introduction of the procedure, our highly trained interventional radiologists have been providing prostate artery embolization (PAE) as a treatment option for patients suffering from symptoms of an enlarged prostate. Currently, we are one of the busiest centers in the region. Additionally, part of our team is composed of sub-specialized radiologists who are experts in prostate and male pelvic imaging.  We offer multiple approaches to performing the procedure both from the radial artery (wrist) and femoral artery (groin).  

Dedicated to helping you through your treatment journey.

Our physicians are available 24/7 to ensure you are well taken care of from the time of consultation through your treatment and follow up.

State of the art imaging with subspecialty trained physicians.

Fairfax Vascular Center is part of Fairfax Radiology Centers, the largest and oldest diagnostic radiology group in the metro DC and surrounding region, allowing us to provide our patients with leading edge imaging technologies and the most experienced diagnostic and interventional radiologists with subspecialty training.

Team approach to care.

We strongly believe that multidisciplinary teamwork results in the best care and outcomes for our patients.  Our interventional radiologists are among the few that provide the option of prostate artery embolization and work with some of the best urologists in the region to co-manage and treat patients suffering from symptoms of an enlarged prostate.

Common Questions

  • How is BPH diagnosed?

    Your doctor will help you evaluate your symptoms and their impact on your daily habits. To confirm the diagnosis, other tests such as digital rectal exam, urine flow study, prostate-specific antigen (PSA) blood test, or ultrasound or prostate MRI may be used.

  • Is PAE effective?

    Research shows that typically the technical success (being able to perform the procedure successfully) is close to 100%. Of these patients, 90-95% of men will have symptomatic improvement after PAE. The overall reduction in the symptoms in most studies has been shown to be between 70-80%. The overall reduction in the size of your prostate gland is approximately 30-40%. Prostate size does impact the overall success of the treatment. Small prostates may be better suited for surgical alternatives. This will be discussed in detail during your clinical consultation. 

  • What will I feel during the procedure itself?

    You can expect slight discomfort for a few seconds when the local anesthetic is injected. As the anesthetic quickly takes effect, the skin and deeper tissue will be numb and you should feel no pain. Then, as the contrast material is injection, you may feel a temporary tingling or warming sensation.

  • How long will the procedure last?

    Each PAE procedure is different. Depending on the severity of the BPH, it typically takes from 1-3 hours.

  • What should I expect after PAE?

    Post-procedure, you may feel tired and should limit activities for a few days. The most common complaints are pubic pain, burning with urination and the frequent urge to urinate. These are typically most prevalent within the first 3-4 days. Your interventional radiologist will work closely with you to manage your symptoms. Within a week, you should be able to return to normal activities. Full benefits from PAE will happen gradually over a few months as the gland shrinks; typically the earliest the results are experienced is at the one month mark.

  • Does PAE exclude me from other treatments?

    No, infact PAE is often used pre-operatively to prevent blood loss. A patient who has had PAE can have TURP or any other surgical procedure, and vice versa. PAE can also be repeated in the future in the event of recurrence of symptoms.

Our Physicians

Paul Reha Butros, M.D.

Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Read more

Paul Reha Butros, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Medical School

Baskent University School of Medicine
Completed 2005

Residency

Detroit Medical Center - Wayne State University
Completed 2012

Fellowship

Massachusetts General Hospital/Harvard Medical School
Completed 2014

Miami Cardiac and Vascular Institute
Completed 2015

Board Certification

American Board of Radiology - Diplomate
2012

Professional Affiliations & Memberships

American College of Radiology
American Medical Association
American Roentgen Ray Society
Medical Society of Virginia
Radiology Society of North America
Society of Interventional Radiology

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Alain T. Drooz, M.D.

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Alain T. Drooz, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of North Carolina

Residency

New York University Medical Center
Completed 1988

Fellowship

New York University Medical Center
Body Imaging
Completed 1989

New York University Medical Center
Interventional Radiology
Completed 1990

Board Certification

American Board of Radiology
1989

Professional Affiliations & Memberships

American College of Radiology
Radiological Society of North America
Society of Cardiovascular and Interventional Radiology
Society of Vascular Medicine and Biology - Fellow
Fairfax County Medical Society

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Aaron R. DuCoffe, M.D.

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Aaron R. DuCoffe, M.D.

Joined Practice:
Body Imaging
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Emory University School of Medicine 
Completed 2013

Residency

University of Florida College of Medicine
Orthopaedic Surgery
Completed 2014

Georgetown University Medical Center
Diagnostic Radiology
Completed 2019

Fellowship

United States Department of Health and Human Services 
Healthcare Policy/Quality - Opioid Safety
Completed 2015

Emory University School of Medicine 
Vascular & Interventional Radiology
Completed 2020

Board Certification

American Board of Radiology 
Board Eligible 2021
Completed 2018

Professional Affiliations & Memberships

Radiology Society of North America
Society of Interventional Radiology 
American College of Radiology
Reviewer for Pain Medicine
National Ski Patrol

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Allen E. Joseph, M.D.

Allen E. Joseph, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Read more

Allen E. Joseph, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Body Imaging
Medical School

Boston University School of Medicine
Completed 1984

Residency

Northwestern University Hospitals
Diagnostic Radiology
Completed 1989

Fellowship

Northwestern University Hospitals
Angiography, Visceral Imaging and Interventional Radiology
Completed 1990

Board Certification

American Board of Radiology, 1989
Vascular and Interventional Radiology, 1998

Professional Affiliations & Memberships

American Roentgen Ray Society
Radiological Society of North America
American College of Radiology
Society of Cardiovascular and
Interventional Radiology
American Medical Association
Fairfax County Medical Society
Chesapeake Interventional Radiology 
Society

Accolades

Top Doctor
Arlingtonian Magazine
Northern Virginia Magazine
Washingtonian Magazine

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Michael G. Karnaze, M.D.

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Michael G. Karnaze, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Kansas School of Medicine
Completed 1982

Residency

Mallinckrodt Institute of Radiology
Completed 1987

Fellowship

Alexandria Hospital
Interventional Radiology
Completed 1988

Board Certification

American Board of Radiology
Diagnostic Radiology 1987
Interventional Radiology 1995

Professional Affiliations & Memberships

Society of Cardiovascular and Interventional Radiology
Chesapeake Interventional Radiology Society (President 1996)
American Heart Association
American College of Radiology
Radiology Society of North America
American Roentgen Ray Society

Accolades

Top Doctor 
Washingtonian Magazine
Northern Virginia Magazine

Close
Hong Lim, M.D.

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Hong Lim, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Medicine & Dentistry
Completed 2001

Residency

University of Medicine & Dentistry
Completed 2006

Fellowship

Baptist Cardiac and Vascular Institute
Completed 2008

Board Certification

American Board of Radiology
2006

Professional Affiliations & Memberships

Radiological Society of North America
American College of Radiology
Society of Interventional Radiology

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David J. Spinosa, M.D.

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

David J. Spinosa, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

Tufts University School of Medicine
Completed 1984

Residency

Georgetown University Hospital
Radiology
Completed 1992

New England Deaconess Hospital
Surgery
Completed 1987

Fellowship

University of Virginia
Angiography and Interventional Radiology
Completed 1993

Board Certification

American Board of Radiology
Radiology - 1992
Angiography and Interventional Radiology - 1995

Professional Affiliations & Memberships

Society of Interventional Radiologists
American College of Radiology

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Mustafa M. Syed, D.O.

Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
Read more

Mustafa M. Syed, D.O.

Joined Practice:
Diagnostic Radiology
Vascular & Interventional Radiology
Medical School

New York College of Osteopathic Medicine

Completed 2011

Residency

Mount Sinai West Hospital Center 

Completed 2016

Fellowship

Mount Sinai Hospital, Vascular and Interventional Radiology

Completed 2017

Board Certification

American Board of Radiology, 2017

Professional Affiliations & Memberships

Radiological Society of North America

American College of Radiology

American Board of Radiology

Society of Interventional Radiology

 

 

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Jay D. Varma, M.D.

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Read more

Jay D. Varma, M.D.

Joined Practice:
Diagnostic Radiology
Ultrasound
Vascular & Interventional Radiology
Medical School

University of Maryland
Completed 1996

Residency

Boston University Medical Center
Completed 2001

Fellowship

Harvard Medical School
Completed 2002

Board Certification

American Board of Radiology
Radiology - 2001
Interventional Radiology - 2003

Professional Affiliations & Memberships

Cardiovascular and Interventional Society of Europe
Chesapeake Interventional Radiology Society 
Medical Society of the District of Columbia
Society of Interventional Radiology
American Roentgen Ray Society
Radiological Society of North America

Accolades

Top Doctor
Washingtonian Magazine
Northern Virginia Magazine

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Related Resources

Available at the following location

Fairfax Radiology Vascular Center

Fairfax Radiology Vascular Center

8505 Arlington Boulevard
Suite 400
Fairfax, VA 22031
United States

Tel
703.698.4475
Fax
703.573.4237

Request a Telephone Consultation

Please provide the following information and one of our physicians or experienced staff members will call you back shortly.

If you need an immediate appointment, please call 703.698.4475.